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Birth Control Pills for PCOS

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Old 05-24-2011, 01:23 PM   #1
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Default Birth Control Pills for PCOS

I'm no doctor, but this was so interesting to me. And in the event any PCOS patient is out shopping for BCP, you may want to bring this stuff up with your doc by name and voice any concerns.

IME, I do best on monophasic. Triphasic pills make me feel crazy with the shifting hormone dose. My PCOS already bops around and I need stability, not more bopping around. "Tri" is usually in the name somewhere but not always. (Ex: OrthoCyclen vs Orthotricyclen)

YMMV.

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-----------------
Summarized from Hormonal Balance book by Scott Isaacs and Neil Shulman

pg 178 - 181
"Synthetic progesterone, called progestin, is not exactly like real progesterone. Progestins stimulate both the progesterone receptor and the androgen receptor and are said to have androgenic activity. When it comes to PCOS I recommend birth control pills that have progestins like drospirenone, desogestrel, or norgestimate. These progestins have the least amount of androgenic activity. The best progestin, drospirenone actually blocks the androgen receptor. It was developed specifically for women with androgen excess. Drospirenone is found in the product Yasmin, which is the most frequently prescribed pill for PCOS. It has a chemical structure similar to the androgen blocking medication spironolactone. It also has mild diurectic properties, so there's less fluid retention and bloating than with other OCPs. Yasmin can also raise potatssium levels which can improve insulin resistance. A side effect can be that potassium levels are too high, so regular blood tests are necessary. Because Yasmin and spironolactone have similar actions, it is inadvisable to take both of these medications at the same time."

Pg 195
"Natural progesterone and the progestins desogestrel, norgestimate, and drospirenone are less androgenic and cause less insulin resistance. Desogestrel, norgestimate, and drospirenone are available only as combination tablets with estrogen.

Desirable Birth Control Pills for PCOS
  • Yasmin
  • Yaz
  • Apri
  • Desogen
  • Orthocept
  • Ortho-Cyclen
  • Ortho-Tri-Cyclen

Natural Progesterone Products
  • Prometrium (micronized capsules)
  • Crinone (gel)
  • Prochieve (gel)
  • Progestasert (IUD)

BCP Medications that Contain Desogestrel
  • Apri
  • Cyclessa
  • Desogen
  • Kariva
  • Mircette
  • Ortho-Cept

Medication That Contain Norgestimate (BCP unless indicated)
  • Ortho-tri-cyclen
  • Ortho-tri-cyclen Lo
  • Ortho-Cyclen
  • Prefest (hormone replacement therapy)


The progestins levongestrel, norgestrel, and norethindrone have high androgenic activity.

pg 195

For reasons still not understood, syntethic progestins and to a lesser extent, natural progesterone increase insulin resistance and raise blood sugars levels. Synthetic progestins have a more potent effect on insuline sensitivity and have been known to cause diabetes in many cases. Most women who take progestins for long periods of time experience weight gain in the belly. Increased belly fat worsens insulin resistance, raises blood sugars, and increases risk of developing diabetes. "

"The progestins medroxyprogesterone, levongestrel, norgestrel, and norethindrone are the worst in terms of the effects of excess androgen, insulin resistance, and weight gain. "


Contain Norethindrone
  • Aygestin
  • Micronor
  • Nor QD
  • Activella
  • Brevicon
  • FemHRT
  • CombiPatch
  • Estrostep Fe
  • Loestrin
  • Microgestin

Contain Levonorgestrel
  • Nordette
  • Norplant
  • Plan B
  • Climara Pro Patch
  • Aviane
  • Alesse
  • Seasonale
  • Lessina
  • Levlen
  • Levlite
  • Levora
  • Portia
  • Preven
  • Mirena

Contain Norgestrel
  • Lo/Ovral
  • Low-Orgestrel

Contain Medroxyprogesterone
  • Provera
  • Dep-Provera
  • Lunelle
  • Premphase
  • Prempro
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Old 05-24-2011, 01:38 PM   #2
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OMG I take Lutera and this is what it says:

(Levonorgestrel and Ethinyl Estradiol Tablets USP)

So I guess I should switch to something on the top of the list? *sigh*

This was prescribed by an old doctor so maybe my new doctor didn't realize? I've been taking it for YEARS!
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Old 05-24-2011, 01:46 PM   #3
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Thanks for posting! I think it's so helpful to understand which hormonal methods work for PCOS and why. I was put on Desogen at 22 and that was like a miracle drug. Orthotricyclin was a disaster. Now I know why!
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Old 05-24-2011, 02:04 PM   #4
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Beerab: That's up to you. Bring it up with your doc.

junebug41: Yeah, OrthoTriCyclen was awful for me too. That's why OrthoCyclen. Usually the name hints at it because there is "tri" in it somewhere if it is the triphasic formula.

Isn't it interesting? Keep in mind that not all PCOS patients struggle with the elevated androgen thing. We come in at least 5 types. But worth pondering if you've got the androgen or IR thing going or have concerns. I'd def borrow the book from the library again!

I started on Nordette and when I moved countries I was on a bunch of the tri's before settling down to Ovcon 35 and finally Ortho Cyclen (sprintec generic too). I did the Micronor mini pill post pregnancy and felt crazy but I chalked that up to new mom nutty.

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Old 05-24-2011, 02:53 PM   #5
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I am going to bring it up- anything that can help I'll take! I just received a 3 month supply so I'll finish that up and then change I guess. Thank you so much for the information
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Old 01-29-2012, 12:51 PM   #6
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This helped inform me a lot!

I take the generic of Yaz, and wasn't sure if it was the best thing to take.

Thanks!
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